Sports mouthguards.
A guard only protects if it is worn, and it is worn if it fits and the athlete can breathe and speak in it. That is the whole argument for custom fabrication.
Custom against the alternatives
Stock guards are held in place by the athlete biting on them, which means they interfere with speech and breathing and are frequently removed during play. Boil-and-bite guards fit better but thin dramatically over the areas that need the most material, because the athlete's bite displaces the softened material.
A custom guard is made to an accurate cast, retains without being held, and carries controlled thickness where protection matters.
The practical difference is compliance. An athlete with a comfortable guard wears it; one with an uncomfortable guard finds reasons not to.
Thickness and coverage
Occlusal and labial thickness are where protection comes from, and the appropriate amount depends on the sport. A contact sport with a high risk of direct impact warrants more than a low-contact one.
Coverage should extend to the distal of the second molars where possible and over the labial to a comfortable sulcus depth, with the palatal edge trimmed back so it does not provoke gagging.
Tell the laboratory the sport and the athlete's age. Both change the specification.
Patients in orthodontic treatment
A patient in fixed appliances needs a guard designed around the brackets, with space to accommodate them and enough resilience to tolerate tooth movement without needing remaking every few weeks.
It protects the lips and cheeks from the appliance as much as it protects the teeth from impact, which is a meaningful benefit in its own right.
Say that the patient is in treatment and roughly how long remains. A guard made without allowing for it will not seat within a month.
Growing patients
Children and adolescents outgrow guards. A guard made for a mixed dentition will not fit once the permanent teeth erupt, and one made mid-growth may need replacing within a season.
That is not a fault and it should be explained when the guard is provided. Review fit at recall and remake when it no longer seats properly — a guard that has become loose offers materially less protection.
Consider colour and personalization for younger patients. It sounds trivial and it measurably improves the chance the guard is actually worn.
Records and care
An accurate impression or scan capturing full clinical crowns, the sulcus depth and the opposing arch, with a bite record. A distorted impression produces a guard that rocks, and a guard that rocks is uncomfortable.
Give the athlete cleaning and storage instructions — rinse after use, clean with cool water, store in a ventilated case away from heat. See appliance care.
What the evidence supports
Custom-fitted guards are consistently better retained and better tolerated than stock or boil-and-bite alternatives, and better tolerance translates directly into compliance.
Protection depends on adequate material thickness in the right places, which is precisely what a boil-and-bite guard loses when the athlete bites into the softened material and thins it over the labial and occlusal surfaces.
For a young athlete in a contact sport, the comparison is not between a custom guard and a cheaper one — it is between a guard that is worn and one that is in the kit bag.
What to put on the prescription
Tick Night Guard under Procedure and specify that the case is a sport guard, or write it under Special Instructions. State the sport, the arch, the patient's age, and any colour preference.
Note whether the patient is in orthodontic treatment and whether the guard needs to accommodate appliances.
More in Removable Prosthetics
Send a case
Digital scans and conventional impressions are both accepted. Cases move by UPS and Purolator, and Fairmont works with practices throughout British Columbia and across Canada.